Evaluation of Clinicopathological findings in Resected Serous Cystic Neoplasm

Abstract

Introduction: IPMN is a common cystic neoplasm of the pancreas. It can be divided into main pancreatic duct type ,branch pancreatic duct type and mixed type. The malignant transformation rate of branch pancreatic duct IPMN is lower than that of pancreatic surgery, because the complication rate of pancreatic surgery is high, and the endocrine and exocrine function is abnormal after operation,So most patients need long-term follow-up. International consensus guidelines for the management of IPMN were first formulated in 2006 and subsequently revised in 2012 and 2017. Also,the AGA guideline in 2015, European guideline( 2013) and Guidelines for Cystic and Solid Tumors of the Pancreas in China(2015). All of these guidelines were constructed based on expert opinion and not on robust clinical data.The main limitation of the original Sendai guidelines was that it had a low positive predictive value resulting in many benign neoplasms being resected.However, although the updated guidelines resulted in an improvement in the positive predictive value over the Sendai Guidelines, the results of several studies validating these guidelines demonstrated that its positive predictive value remained low.Although these guidelines were associated with high negative predictive values, some investigators have demonstrated that some malignant IPMNs may be missed. Method: All cases of IPMN confirmed by pathology after operation in our hospital from 2000 to 2018 were collected. According to the above guidelines, the specificity and sensitivity of the guidelines in this group of cases were compared. Result: In this group of cases, there was no significant difference between the guidelines. Conclusion:There is no clinical guideline that can give full consideration to specificity and sensitivity. Individualized treatment should be given to patients according to their clinical characteristics and surgeon's surgical techniques.